Sentara Cancer Network dietitian specializes in cancer nutrition

For cancer patients undergoing treatment, a key component to successful healing is to maintain a healthy weight.

Some patients see their illness as an opportunity to shed unwanted pounds, says Vonia R. Ickes, a registered dietitian with Sentara Cancer Network, but the goal is maintenance so the body can repair itself.

"If they're better nourished, they're likely to tolerate treatment better," she says. Those who become malnourished are more prone to infection and, if they become too weak, the doctors have to halt treatment, which in turn makes it less effective.

One of only a half dozen dietitians in the state to hold a certification in oncology nutrition, Ickes, part of the Sentara Cancer Network, consults mostly with patients at high risk for nutritional deficiency — those with head and neck or gastrointestinal cancers, whose treatments typically extend over several weeks. Still, there are no hard-and-fast nutrition rules for oncology patients as every individual reacts differently to treatment, she says.

Primarily, Ickes encourages patients to focus on "nutrient dense" or high-calorie foods and staying hydrated. She urges them to set aside standard notions of healthy eating during treatment, and instead invites them to consume high fat, high energy foods.

"Always go for what's going to provide the most calories first," she says.

As some people lose their appetite, Ickes recommends foods that can provide the greatest benefit in the smallest amounts. She advises multiple small meals or snacks.

"For someone with a poor appetite, a large amount is a total turn-off," she says. "They're more likely to eat a small amount."

One booster that's effective and versatile is "fortified milk," in which she mixes nonfat powdered milk with whole milk to boost its nutritional content to 215 calories and 16 grams of protein per serving from 150 calories and 8 grams protein for whole milk.

"Then you can use that milk in mac and cheese or mashed potatoes," she says. Likewise, using whole milk is better than using skim (90 calories). "After treatment, they can go back to a lower fat diet," she says.

For nutritional supplements, such as Ensure and Carnation, Ickes advocates always buying the "plus" variety, which typically bumps up the calorie content from 240 to 350.

Vegetables are fine for those patients that can tolerate them, but to boost efficacy, Ickes advises adding a cream or cheese sauce in order to increase the calories.

For many patients, their tastes may change either temporarily or permanently.

"They might need more of an herb or spice. Some things might taste salty. They might want to add a little sugar," says Ickes. She puts a positive spin on such changes for her clients, encouraging them to experiment and try different foods, ones that they might have disliked in the past. "They might find a new food good," she says.

Want an appointment?

Vonia R. Ickes, MS, RD, CSO, is part of the Sentara Cancer Network and visits several Sentara radiation sites each week; appointments can be scheduled on Monday and Tuesday afternoons from noon to 3 p.m. at Sentara Norfolk General by calling 757-388-2066.